Formulir Usulan Calon Penerima Bantuan
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FORMULIR USULAN CALON PENERIMA BANTUAN KUALIFIKASI S1 PAUD TAHUN ANGGARAN 2016 Nama : .......................................... NIP. : ........................................... Pangkat/Gol Ruang : ........................................... NUPTK : ........................................... NPWP : ........................................... Tanggal Lahir : ........................................... Pendidikan Terakhir..........................................: Jml. Jam Mengajar : ...... X per-Minggu Masa Kerja : ........................................... Status Guru : GTY/GTT/HONDA/Guru Bantu/PNS (Coret yang tidak perlu) Nama Satuan PAUD : ........................................... Status Satuan PAUD : Negeri/Swasta (Coret yang tidak perlu) Jumlah Rombel/Kelas..........................................: Jml.Murid per-Rombel.........................................: Nama Perguruan Tinggi........................................: Jumlah Semester : ........................................... IPK(Min 2,5) : ........................................... Lampiran 1. Fotocopy NUPTK Yang Mengusulkan 2. Fotocopy NPWP 3. Fotocopy berlegis Ijazah Terakhir 4. Fotocopy berlegis SK Pertama s.d Terakhir 5. Fotocopy IPK 6. Fotocopy Rekening …………………………….
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Transcript of Formulir Usulan Calon Penerima Bantuan
FORMULIR USULAN CALON PENERIMA BANTUAN KUALIFIKASI S1 PAUDTAHUN ANGGARAN 2016
Nama : .........................................................................................................
NIP. : ..........................................................................................................
Pangkat/Gol Ruang : ..........................................................................................................
NUPTK : ..........................................................................................................
NPWP : ..........................................................................................................
Tanggal Lahir : ..........................................................................................................
Pendidikan Terakhir : ..........................................................................................................
Jml. Jam Mengajar : ................... X per-Minggu
Masa Kerja : ..........................................................................................................
Status Guru : GTY/GTT/HONDA/Guru Bantu/PNS (Coret yang tidak perlu)
Nama Satuan PAUD : ..........................................................................................................
Status Satuan PAUD : Negeri/Swasta (Coret yang tidak perlu)
Jumlah Rombel/Kelas : ..........................................................................................................
Jml.Murid per-Rombel : ..........................................................................................................
Nama Perguruan Tinggi : ..........................................................................................................
Jumlah Semester : ..........................................................................................................
IPK(Min 2,5) : ..........................................................................................................
Lampiran
1. Fotocopy NUPTK Yang Mengusulkan2. Fotocopy NPWP3. Fotocopy berlegis Ijazah Terakhir4. Fotocopy berlegis SK Pertama s.d Terakhir5. Fotocopy IPK6. Fotocopy Rekening …………………………….
